Amanda:
Hey guys, welcome back to the podcast. I am Amanda,
Laura:
I'm Laura,
Kendra:
...And I'm Kendra.
Amanda: And we are so excited today because we have a guest who we met at ASEP in Philadelphia, American College of Emergency Physicians, if you don't know what ACEP is it's Leticia Vaca Williams, and she is a therapist, speaker and owner of Urban Health Group, which is a boutique-style concierge for healthcare navigation and mental health support. That sounds so amazing. We're going to have to ask you about that because that is something I've never heard of.
Leticia has a special interest in eliminating health care disparities and reducing health care biases for Black, indigenous, and people of color. And not only that, she is a certified trauma specialist who helps health care workers with things like what we're going to talk about today, which is vicarious trauma.Welcome to the podcast, Leticia. Thank you so much for joining us.
Leticia:
Of course. Thank you for having me. We had such a nice chat at the conference. It's nice to be able to further the discussion.
Kendra:
Yes, we will get to it. And we are excited because this was something that we were able to name, you know, after the fact, after we had suffered so long and Smushed it all down and then wondering why we wouldn't even be at work and we get triggered by something and all of a sudden you're busting out like, Oh my God, you know, I just start crying or doing all the things and you're like, what is wrong with me?
And knowing that I just had a string of three shifts where I saw some pretty bad stuff. So, so why don't we start. Introduce yourself, Leticia, tell us about you, your training, what you do on the daily, where you live.
Leticia:
Yes, so I, I am. I feel like I'm just a person, right? But I always underline how much training and education and all that that goes into being a trauma therapist.
But what really led me to going into the field and I studied my master's in social work with emphasis on community mental health. It's because of my own family's lived experiences, having such a hard time connecting to quality care and multiple family members dying prematurely for treatable conditions.
I didn't know that support was actually available. And so I went to study social work because I wanted to understand the system and how it impacts individuals. And I learned there are medical social workers, people in the hospital that can help people cope with the experience of being hospitalized, but also connect them to resources.
So I got excited that I could be the change that I know that family members need when they're facing like the hardest times of their life. And I was able to work in different parts of the hospital, supporting people in the ER, ICU, outpatient, even the psychiatric system. I was like, really wanting to study the whole system and how a person can move about, but I noticed, you know, the hospital is only like 1 point on a person's journey.
And that there's more support needed beyond the hospital walls. And while doing like bedside crisis intervention, I was like, well, what happens when they go home? Some of the discussions and things that we talk about in the hospital, we kind of like send them on their way, good luck. And so that's what led me to explore psychotherapy even more.
Being able to support people with the emotional parts that come up. So, I, I saw the gap, you know, there's something that's happening between your everyday lived experience. And then when you're in the hospital, so Urban Health Group is that bridge between navigating your health care, but also connecting to mental health support.
When needed, and I've been able to kind of put that together in a very unique way. That really focuses on preventative care that focuses on these upstream approaches that can we like, have this conversation before crisis happens. So I don't have to think about do I want a feeding to do? I want, you know, my ex-wife making these decisions for me, you know, in case of a crisis.
So I really have. gobbled up everything that I can learn about the system and how people are impacted in both positive and negative ways and really wanting to address the gaps. The work that I'm currently doing and interested in is really helping the, the healthcare heroes. We know in the past three years, you all have been slammed, you know, with trying to manage what is so unimaginable and really finding that healthcare workers need, need support as well.
You know, they, they are not these robot helping machines. They are human beings with their own personal lives that may be needing some more support. So of recently, I want to say in the past 2 years, we've been doing more intentional directed work with healthcare workers and physicians and my, I have a soft spot for ER workers.
My husband is an ER doc and a lot of our friends are ER, ER folks. And we, we can talk about it, but we can also heal through it. And I think that's the missing point of not just talking but caring through some of these challenges, so I'm here based in Oakland, California. I did my training at Highland Hospital.
So working in a level 1 trauma center seeing what's I think it's now a level 1, but it was a level 2 trauma center seeing all the different ways that people can be impacted and in ways that you can't even imagine sometimes. And the human psyche can't always take it all in, but we are impacted. So I like being able to contain spaces that can be overwhelming and say, let's, let's care through it.
I'm also an EMDR therapist that it stands for eye movement, desensitization and reprocessing. It's a type of therapy that is extremely useful and helpful for folks who are dealing with trauma, you know, PTSD or recent events to really get some emotional relief. So I've been really excited about the work that we're doing with groups.
Around getting some relief and I know that's like a mouthful, but I've been able to put it all together in a way to say, let's, let's take care of our communities by also taking care of ourselves.
Kendra:
Wow, that's amazing. And what an intuitive thought though, you know, because we have been talking about burnout for a while, but when we had the onslaught of the pandemic, that was really a way to expose stuff that was really simmering under the surface.
And what, what a, the, the blessing wasn't in the pandemic, but on this side, everything that has come out of it and just, the conversations that were started and are continuing that's where, you know, we have seen just an amazing amount outpouring of just, hey, we're having these conversations now and it's out in the open and that's normalize it.
So thank you so much for what you're doing in your space. So if you could help our listeners, what is vicarious trauma? And are physicians really at higher risk than the general population?
Leticia:
Yeah, there's a lot of misconceptions. We think about trauma as the big T, the thing that happens to me directly.
Trauma is the way that a person is impacted. So it can even be like you know, that nurse yelled at me, or I don't like that, it feels like that patient didn't trust me and it really impacted my work. Trauma is about the emotional experience being really overwhelming. Now vicarious, which is considered secondary trauma.
You're hearing stories. You're witnessing the hardships and also like the atrocities of what can happen. It's not happening to you, but you're having an experience as if it's happening to you. And so trauma and traumatic reactions and responses really respond or warn like a directed approach for care.
It is different than burnout, and we like to talk about burnout because it's a little bit easier, right? A little bit more socially acceptable to say I've been traumatized by something in a way that impacts the way I sleep. How I show up in my family, not able to experience joy or pleasure. Ruminating on things that are way out of my control and my sense of self and worth is becoming diminished.
Burnout can look like I'm really exhausted. I'm displeased with work and so sometimes the line is very blurred and we think it's one thing when really it's a traumatic response that needs some attention. ER physicians are exponentially more and that's just me making up. That's not a scientific study.
There's actually not a lot of studies on our physicians and their emotional experiences. So we're kind of gathering observationally what folks are experiencing and there, and there has been some research and we look at the impacts, right? We know that physicians do have suicidal thoughts.
They do take very extreme measures, and that one study even showed that up to 400 physicians commit suicide each year. So we, we see it from the back end, the effects on the extreme, but there's like some experiences happening that are leading up to That kind of expression. So, yes, just by the nature of the work, you're exposed to a lot more experiences than the general public could ever even imagine, and you're expected to, like, help and save these folks lives.
Kendra:
All while making sure our patient experience scores remain in the green,
Leticia:
Replay everything I assessed and what I did, who I communicated with. And you know, the margin for error is actually really small. So the work that it takes to kind of compartmentalize, maybe the emotional component is, it gets missed, it gets lost, but it's also very important to the human part of you who is like, wow, that was, that was a lot.
Amanda:
I think we feel it, we just didn't have words for it, you know.
Kendra:
That's exactly what I was gonna say, A. That is, to have words, to name it, that in itself is so incredible. Like, that gives... So much meaning to like, Oh, okay. Yes. I have to compartmentalize because that trauma that came in, I still have six more hours of the shift.
It very well could get something else coming through those doors, especially at a busy center, like we all work and to not know exactly what it is. But then now that we're having the talk and we're discussing it and we're normalizing, like just to have words to, to put with it, that is huge.
Leticia:
It's huge. It can be liberating because when I'm in the therapy room with physicians, they're like, what?
It's like, yeah, you sound like a human being who who had a very normal reaction to a very abnormal situation They're like, but yeah, it's all of those it's and and but it's I feel overwhelmed and I'm able to care for the next person giving them my highest acute attention to their need even if it's a call for a sniffle.
Right. And the way that we find that folks are having a hard time as I start having less tolerance for certain things, find myself more snappy and judgmental and, you know, we've, we've seen it. I've, I've definitely seen it how, you know, er teams can operate sometimes a little rough, but we, the ultimate goal is that the patients get their needs met.
Right. I need to see that person in 3 because they've been waiting for 2 hours. You don't know what it is. It could be something that really needs, you know, further imaging or needs, you know, more attention. So you're having good, you're having, when you're having reactions, it lets me know, oh good, your system is awake.
When you're not and you're kind of numbed out, that's also a concern too, being desensitized to things that are actually really concerning.
Kendra:
Yeah, that's really good that you make that point, because there are some very serious tolls that vicarious trauma takes on physicians. Can you elaborate on that a little bit more?
Leticia:
So there's, it's not just the nature of the work, but The added responsibility and liability for the type of care, so, we see quality of care, maybe even medical errors, there could be things that have nothing to do with work and going on at home, we know that, you know, there's folks who are experiencing domestic violence or intimate partner issues, even as physicians, substance abuse issues, their children are not listening, their partner is fussing, or they may have their own health issues that they are trying to manage on top of work. So, when we look at the folks who need the most care, might be the ones who are dealing with the most crises, they're the most exposure to overwhelming situations. But there's a stigma around seeking care even as care providers. And so I, I really wanna highlight that we, we know the numbers, but somehow we just kind of like put it to the side. We know that in the US the pandemic really pushed physicians to all time high numbers of 63 percent of folks for ER, not ER physicians, but just doctors in general reporting burnout symptoms. That's a lot. So it not just impacts the person who's trying to contain their emotions, but their relationships, how they feel about the work, how they're able to show up in their own lives, let alone, you know, the room.
Laura:
Yeah, that is, I mean, it's interesting. I think so many of us. Like we have to shove things down to continue to function, but when we start to reflect on the weight of what we have shoved down, it's really eye-opening. And I think back, I mean, even just, I have a very visual memory. And so I have a whole slideshow of traumatizing images, not to trigger anyone, but that, I picked up over the years working in the emergency department. And I know I'm not the only one.
So what are some of the tools that you use with physicians to help combat this vicarious trauma that we experience?
Leticia:
One of the tools is actually a lot of psycho education around how symptoms can show up. It looks so different from person to person that you may not even recognize that you're, you've been impacted in such an alarming way.
I can give an example of myself having worked in the ER. We had two pagers, a black one and a red one. The red one means you need to get there now, right? And so having a system, meaning a body that's always on alert, ready. That didn't shut off necessarily when I went home and I was killing it. I was able to support all these people and do all these things.
And it was such a grace and kindness that didn't turn off when I went home to the point where I broke out in shingles. So for me, it didn't impact me emotionally or like in my mind, but my body cried out. And I did this because it was on my face, like you can't ignore it. So some of the signs can look so subtle and then sometimes it's like, very overt around what you're experiencing.
So the tools that we use around getting to learn what's your traumatic response? How does it show up for you? Oh, I'm I'm disengaged from running and playing soccer. I love those things. This is stories that I've heard. I'm with my kids and I, I don't even have it in me to talk with them. They're saying some funny jokes.
I'm not laughing and I don't like to be that. Disengage from my family. I go to work and I feel like I'm a failure because that last client, I couldn't, not client, patient, I couldn't help. And I'm reviewing the chart, even if they moved in patient, right? You're still trying to follow along. So it looks very different from person to person.
And we get to learn what's your, how does it present for you? How will you know you're impacted? Using a lot of mindfulness tools, I found that the guidance, surely I can hand you a book or send you an article and say, I'm waiting for this. It's great, but to have someone to help you kind of tease it out.
So you don't have to do it on your own. That is what I've been able to be really proud about in my therapeutic relationship with my physician. I can do it with you. I mean, I'm interested. I'm curious too. I said, I need you to be well. What if I go to the hospital? I want you all burnt out and tired and cranky.
I want you to be able to have tools to take care of yourself so that you can show up in the best way because you're still showing up at a high level. Imagine if you were doing that well.
Laura:
Yeah. Oh, that's awesome. I love that. And I think that's so important because so many of us, through our training, we were trained to disassociate from our bodies because we couldn't take time to eat.
We couldn't take time to sleep. We couldn't take time to a lot of times even go pee. And so that's where we are. And so we don't, we don't know what our trauma response is.
Leticia:
Yeah, and then some of that is a symptom of the organization, right? You do need to eat. You do need to go to the restroom. You do need a couple minutes to gather yourself and that can happen in moments.
So some of the tools that we go over is how do I incorporate what I need even though I'm time limited. So I don't deprive myself, my mind, and my body from getting those moments of care. And then it builds, and then it builds. But part of the training, you know, that's part of where the issue is. The organization also supports that because, you know, the ER's 24 hours, it doesn't close.
And so, even though the human body likes to go to sleep when the sun goes down, an ER physician's mind has to be up as if it's noon. As alert, that's you're going against biology here. Come on. Right. So part of the care practices, I do think it can be acquired. It is not. It doesn't have the and, or, this or that we can learn to take better care in the same environment.
Actually, you have to it's critical, but it is a mind shift change. That's very different than training in the many years that you been in the field and then your colleagues are all doing it. What would it look like for me to sit down, reset my energy, take a deep breath, have a sip of water, go to the bathroom.
That's like two minutes. If, if, if you're, if there's no code, you can take two minutes.
Laura:
Absolutely. Absolutely. You're exactly right. And that's so interesting that so many of us don't, don't know to do that. So in addition to vicarious trauma, are there other issues that physicians are at a particularly high risk for experiencing?
Leticia:
I wouldn't say there's additional issues. Trauma is already loaded. There's the existential concerns. There's the physical, there's the cognitive, emotional. If I posted a list, the wording would have to be so little because there's so many different ways the traumatic responses show up. They can look like depression.
They can look like anxiety. It can look like paranoia, right? I'm really concerned about this thing. If I don't get this done, then there'll be on my back or I'll have a target. All right. It'll look like, I don't know what I'm doing. No, it looks like I need to take care of myself right now. That we can begin to change the language and not pathologizing physicians for having very human experiences to the nature of the work that is being done.
We don't have to wait to someone is to the point where they're suicidal, right? What if I'm a little stressed out and I've noticed that for the past month, that is a great time to say, well, let's, let's do something about it. Let's take care of it. So, it's really creating these opportunities and it, you can do it individually, you absolutely have to do it individually, right?
You have to value your own well being, and that's the language that I'm using more often. This is not luxurious to take care of your mental health. It is critical for your well being.
Kendra:
Thank you. Thank you, Leticia, for those words. Thank you. Yeah. And can we say this again? Can you just say that again? To say that this is not high maintenance.
This is not bougie. This is not over and above. So again, it is not.
Leticia:
And the, the thought that you can do this work and be well and be free and be happy. These are experiences that are underrated, but can become experiences of importance. I personally want my doctor to be happy. I really want my doctor to be well fed.
And rested, those are things that are critical for a human being's well being. Why is it so different for ER physicians? Cause we've said it, right? Well, they just, the crazy ones who just go on and they can, there's a, there is a personality type a little bit, right? There's the folks who can contain that level of uncertainty that comes in.
There is a level of, like, composure you do have to have. So I get the compartmentalizing. All that stuff is fine. But when does it become dangerous for you? When does it become harmful for you? That's what we have an opportunity to look at when you're in proper care. Even burnout. Like, trauma, there's recovery.
Folks, if you're all about the medical model, right? The concept that you're... traumatic experience can be in remission, can be in recovery, that you can actually heal from it, that the symptoms can no longer overwhelm you in the way that they used to. That is a true possibility. And we know that because of neuroplasticity, I wouldn't do this work if I did not believe that change and healing was possible.
Kendra:
Yes. Yes. Yeah. Yeah. Neuroplasticity. Yeah. Neuroplasticity. Yay.
Laura:
So if you had an audience of physicians, which you do right now, what would you tell them about overcoming the stigma of seeking mental health support?
Leticia:
Well, I want to acknowledge acknowledge the stigma is a very true concern. You know, it can impact your livelihood and that.
When you do job interviews, they ask you, is there any mental or physical limitations you have to, you know, doing this work? So, of course, I don't want to limit my options. The concern is valid, but as we, are talking about mental health, it does not have to be an extreme concern. It can be part of your maintenance.
The way that you value brushing your teeth in the morning. No, you know, the harm is probably pretty low if you skip a day or a week, right? It's more difficult if you neglect your emotional and mental health needs over time. And so, Doing more preventative work, that is some of the work that we're doing at Urban Health Group is having emotional well being conversations and wellness workshops where people can start contextualizing it for themselves and saying, Oh, I'm interested in taking better care of myself.
Sure, if you ask anyone that, but we're not always taught that, like, even in our families not certainly not at work, but these are ways that we, it's not too late to learn. We pride ourselves on working really hard. We get kudos for it. We even get awards sometimes. What about taking care of myself?
What's the reward in that? The reward can be, I feel really great. I feel really connected to community. I'm able to receive love and experience joy, that's not necessarily prioritized in our society, but they are experiences of great importance because we start hearing the stories. I'm so unfulfilled.
I think I have to get out of this job. I think I have to get out of this life to find relief. Right? And so, finding maybe neutral ways to engage in emotional well being can be group work. It can look like self care activities. Again, that's not therapy, though. Like, sometimes when you're dealing with vicarious trauma, it does need treatment.
It requires treatment. A plan doesn't mean it has to be pathologized with you have PTSD. No, you're having some experiences that need more directed support. So, the fear, I think sometimes of being diagnosed with something. You want to find a practitioner who's not necessarily preoccupied with searching for pathology that, because you're really having normal reaction to abnormal circumstances.
I'd like to just, that's my favorite understanding of traumatic reactions and responses. If you're alive and not a psychopath, you will have emotions. You will have reactions to life. The traumatic ones are ones that consume us. They hijack us and overtake us. So I want to encourage you to seek support.
You can also share with your provider your concerns, and they should be a partner in your care and let you know what they can or can't do. But the stigma and the ramifications are are real. If you are at the point where your emotional wellness is impacting your, your ability to do the work, you do have an ethical responsibility to take care of yourself first.
In our field, it is, we have a lot of code of ethics, like lots of them, parts of them is if you can't do it, you shouldn't be doing it. And you should seek support and consultation. And I know some, some systems, whether they're, you know, hospitals or physician groups have like a peer support. But these peer supports are also going to work too, right?
So we want to create better infrastructure for physicians to maintain and manage their emotional, their emotional needs. So I'm, I'm really pushing for a system change that says, yes, here's where you can go to learn and experience some decompression. Here are some places that you can go to kind of talk through some of the marital issues or substance issues you're having so that we can keep you.
There's actually a shortage of physicians. So, you know, we need to keep up the workforce and the best working optimal condition. Selfishly for me, right, but you deserve to feel well for you outside of your role as healer or the caretaker, those are the words that I use, you know, er, sometimes that feels a little cold.
There's actually more that goes into the work you do.
Laura:
And the stigma is never going to go away until we normalize this. So we just need to be brave and take care of ourselves. And guess what? Your patient satisfaction scores are probably going to go up if you're not miserable at work.
Amanda:
Yeah. So. Did everyone hear her say, you're a normal human being, if you're a normal human being and not a sociopath or psychopath, you're gonna have feelings and, and staying a human being and not a robot means that we all on some level probably need some support. I'm, I was sympathizing with you because I also, I was breaking out in hives from shoving all of it down and vicarious trauma.
There were, you know. All of us have seen some horrible things. But then in addition to my hives, I also broke out in shingles. So Cause your system said, Oh, you didn't listen the first time. I've been giving you a little warning shots at these little hives. And do you think I listened to it? No, I was, I had shame about it.
I was just like, Oh my God, I can't cut it. So I would double up on Zyrtec or whatever before I went to work.
Leticia:
When our body sends us signals. When our mind can't, you know, do, you know, when it's over writing, you know, you have to compartmentalize yet when it's being overridden by what we're conditioned to believe our body starts speaking, it won't let you sleep.
It says, no, no, no, I need your attention. You've been overworking me. If you're, if you don't listen, your body will start aching. He says, Oh, you don't want to listen. I want to lay down. I do not want to go to work. You don't listen. Your body will, it will, and it's working for your good. Actually it can tolerate a lot until it says, you know what?
I'm not going to do it. We don't want you to push those limits. And what's happening is that people are just hovering close to the limits. For many years. I didn't push the limits, but I'm at the top. What we get to do in therapy, so what would it look like if you had a little bit more, a little bit more space for you?
Would it, what would it even look like if you weren't this like 9, 8 out of 10 stress?
Kendra:
Well, just the thought that you even bringing that up, like, Hey, what would it be like if you were not Mach 60?
Like, what if you were just on cruise control and could code? Like, what if you were like at your best, like modulated, like go everything, all systems go and not like Mach 60? Like, I don't even know if, like, I've never been asked that question , you know, obviously until I asked it myself. But like, what if, what if we asked, started asking people this?
Oh my goodness. That question right there is enough to.
Leticia:
Yeah, it's enough to get excited about.
Amanda:
Yeah, and the thing I just want people to realize, our medical culture isn't going to ask that until we normalize this. They'll let you push yourself to the brink. I mean, that's what we see over and over and over.
So, like, don't feel bad if you're the first person you know to start making boundaries and start seeking mental health support. Like somebody's got to, and we all have to start doing this. We have to normalize it because if you're judged by your results, our results are dismal. Like what we're doing isn't working.
So why don't we just try something different?
Leticia has self care wellness workshops and EMDR groups for healthcare professionals. Like, tell us about that. How do you know which one? What yeah, which one you might prefer or need or what does that look like?
Leticia:
So I'm I'm most excited to talk about the workshop wellness component, but I'll go to like the end right?
Around the crisis management because that's where systems like to go. If someone's really having a hard time 101 therapy can be extremely helpful Now, the work that we're offering is called integrative group therapy. It's an EMDR model that was actually tested during the pandemic supporting physicians with symptoms.
So we're not erasing the fact that you're having experiences, we're just desensitizing how overwhelming you're having your symptom presentation. And so the EMDR groups are one that I really enjoy. I like joy. I like groups in general, because I believe in the power of community healing spaces where you're not isolated in your story.
But We're also really crafty around making sure folks are not activated and triggered by other people. And this particular type of therapy was offered to physicians in Mexico City. And they also did a study in, in Northern Italy. And they saw that when they did their posts and pre tests that folks had less symptoms.
That's all I really care about is that you feel better and that you're able to move through life with a little bit more ease. The fact that you're having responses at all. Is appropriate. That's okay. We want you to be able to manage it and go home and enjoy dinner and have a good night's rest and walk in feeling confident and capable the next day.
That's all we're talking about. So the groups healing health care heroes is something that we started in the past 2 years, specifically for folks who were impacted by coven 19. now, maybe folks are not as impacted by the care that they had to provide during that time. But we know with trauma, there's some immediate responses and there's some delayed ones. Things that show up three months, six months, a year, two years, five years down the road that need attention still. So I would say folks who feel that they're still impacted by the nature of their work where it's impacting your quality of life can get some great relief from the EMDR groups.
Now, what we're doing with the wellness workshops or the self care workshops, because there's two different types, we're actually offering these for emergency groups, the, like the, like the staffing agencies who want to incorporate, incorporate wellness for their physicians, or if the physicians are hired by the hospital, you know, sometimes there's a little tricky about who provides the care to the physicians.
We are offering these workshops to discuss the different topics around maintaining and managing your emotional wellness. And it looks like a 12 part series. Some of it is a listen and learn, but they all integrate grounding exercises. You're facilitated with, they're facilitated by a therapist.
It's not therapy, but you have someone who's skilled in being able to manage groups. And both of them, both the EMDR and the emotional wellness can be done on larger scales. The EMDR groups are mostly known for managing crises at like refugee camps. Again, traumatic experiences. So the way that the human is impacted by great tragedy and atrocity looks very similar.
We get to manage that. We get to be, be able to say, get you to a place where you feel a little bit more functional, a little bit lighter and freer, but it's okay that you're impacted because that, that is abnormal. We are calling that out. It's not you that's deficient and can't handle it and that you're weak.
No, you're a human being who's having a very human reaction to something very terrible. So, if if organizations are interested in how they can begin to create infrastructure of wellness for their health care providers, that is something we provide through consultation and our workshops. But if you're like, you know, I don't want to wait for my organization to figure it out.
I want to sign up for the next one. You can, you know, sign up to join the group. We also do intensives. So EMDR intensives for therapists who don't have the time to go like every week because their schedule changes. EMDR is a more condensed version to get folks some emotional relief by giving them more time to process through some of this stuff.
The word intensive sounds intimidating, but it's actually more gentle and pleasant on the system when you don't have to rush through a 50 minute session, like, I hope I get the most out of it.
Amanda:
So I, I mean, there's probably a lot of listeners that don't exactly know what EMDR. Is like, what sort of things that can help, do you have any examples?
Leticia:
It's becoming more popular and discuss, but what EMDR really relies on is the wisdom of the body to move through emotional disturbances. For example, when a traumatic experience happens, it gets stored in the emotional part of the brain. So that's why when you replay a story, there's certain smells, pictures, images that are attached to it now when they're still and they can get stuck there. So that when you see something again, you're activated.
We call it triggered. Again, and it can make it a little bit more difficult to move through that experience. EMDR actually moves that experience from the negative the maladaptive place that it's been stored in the emotional part to the logical part of the brain. It says, I'm no longer there. You were trained for this.
You can do this. You can take care of yourself to the prefrontal cortex where the logic lives. But when we're stressed. We get stuck in the emotional state, so we use our natural brain's process, which is what happens during REM sleep, right? Rapid eye movement is when your brain is processing and thinking things through.
We get to do that while you're awake. So we can do that through bilateral stimulation, and I believe the right hemisphere is connecting to the left and you're able to move that information in a, in a way that is more logical and also cares for the system. So we can do that through the eyes. We can do it through touch.
But if I tap is my favorite marching and some people use sound where there's different sounds and so we're really taxing the brain to focus on both. The traumatic experience, but also like the new narrative that you want to create about yourself and so it is trippy. But it is highly effective for folks who have symptoms of vicarious trauma, secondary trauma, PTSD symptoms even if something happened this week, right?
So I've had physicians who are like, I had a terrible case. I've been hard. It's been hard to shake. We can do what it's called a recent events where we're not like reprocessing the event. We're working on desensitizing the way your body. Is containing that information and so some of the work that we do is for historical stuff.
And some of it is like, this happened this week and I've had a hard time sleeping. I can't shake it. I'm I feel hyper vigilant when I work with, you know, trying to intubate someone. I'm 2nd, guessing myself, I feel myself a little bit more snappy with my colleagues when they want me to hurry and do something else.
So is a way of bridging. The body wisdom in the mind distortions and alignment for your care. So a lot of people, we don't always know that, but we're storing information for years and a part of us that we're hiding and suppressing. So sometimes we've got a backlog of things that really need to be cleared.
So I can move forward with freedom and I like it because it creates sustained change. Benefits that don't require you once you've cleared it require you to come back to it. You're going to still feel it, but it won't overwhelm you.
Amanda:
So we've had some coaching friends that like, you know, for instance, like, they got named in a medical malpractice case.
And so then anytime they went into the building or something like that, and they said they had great results with EMDR. To not bring the emotional baggage whenever they go into the scenario. I'm also thinking, like, would it work, you know, if you start suddenly second, you, you mentioned intubating or like some sort of procedure that one time it didn't go well and then all of a sudden you're like in your head about it.
All the time. I'm wondering if that would be another example.
Leticia:
It actually works with a lot of different emotional overwhelms. So your therapist would walk, talk with you about what is the thing for you and how does it show up? Because for everyone, it could be something completely different. Sometimes it's even for attendings.
I don't always feel calm. Like I know I feel strongly as a provide provider, but I don't know if I'm that great of an educator. So they may find themselves a little bit more stern with their residents or not as confident or sharing of information. Sometimes it's, you know, things like that around, you know, even leadership positions when there's a lot riding on your decision.
That's the uniqueness around. E. R. Physician specifically is everything is really can be life or death. It your decision making capacity and confidence and skill level and emotional maturity all play into how you show up and care for others.
Amanda:
So maybe, so maybe if you're having anybody who's having like that amygdala hijack where it's going straight to emotion rather than, you know, having a lot of thought I want, is that like a good candidate for EMDR?
Leticia:
Yes. Okay. For sure. Anytime you're being hijacked by emotion, sometimes folks don't know they're being hijacked, but one indicator is that you're highly reactive. To feedback information even things that might seem subtle to someone else, it can look like someone who's extremely irritable and snappy or someone very rigid.
It has to happen like this, where they get really tunnel focus on a specific way of doing things anytime you're emotionally stunted, constricted, overwhelmed. EMDR can create some relief in how you're able to see more possibilities and experience more freedom within your body. Because it's not always happening here, right?
We're one system and that's where folks forget to eat and drink. They realize I didn't go to the bathroom the whole time I've been on shift. That can't be healthy for your system, right?
Amanda:
It's not. It results in hives. And then shingles. So that's awesome. I just, I am just excited to put it out there for people who feel like they're we have, we've talked to so many people who are like, I just feel like I can't do this procedure anymore.
Like this, like panic about it. And, and like there, there are modalities that can help and don't hesitate to go seek them out. For crying out loud, you don't have to get medicine.
Leticia:
It can be topic specific. It's not always like, well, let me tell you, you know, tell me how things were when you were 10 years old.
It's not always that, but sometimes it is. Maybe it's hard for them to do that thing again because they were criticized their whole life. And that feedback they got from that attending really shook them and it reminded them of a time, right? So sometimes it is connected to some past stuff. And sometimes it's just more recent things that shock your system in a way that you didn't even know it would, right?
Sometimes things start impacting you that didn't used to impact you. So we can talk about things topic specific, but sometimes we have to break it down and see where did this take us? Narrative start. Where did this emotional injury occur? Because sometimes it wasn't even in the workplace. But it's showing up at work.
Amanda:
How does somebody get in touch with you? What is, how do they take the next steps?
Leticia:
So, you know, like everyone else, there's a million ways. You can go to our website, urbanhealthgroupinc. org I can be found on Instagram at urban health group, Inc. You can email us at hello at urban health group, Inc. to find more information.
we're pretty responsive. We have an excellent admin person who loves to connect the dots. And sometimes there's talking with folks to just tease out what's possible and we'll send information or referral even if we're not the ones for you. But we want to make sure that folks are seeking care, asking the questions, normalizing having this discussion.
Because it is important that you're connected. It is important that you feel well. And if you don't know what that is, then it's time you start exploring what is wellness for you. And how can you really prioritize your own well being as you're in the field of helping others manage their well being?
Amanda:
Thank you so much. We will have links to all of those ways to contact you in the show notes. Any last thoughts before we close?
Leticia:
Just take care. You're worth it. It's not that scary. It can be, but it's actually not. And... You deserve freedom within your mind and your body and you don't have to wait until a crisis or it's too late.
You're about to blow your top It can be with I want to feel well now. I want to learn that for me So my hope is that we normalize having this difficult conversation not to pathologize but to provide real change on how we can be well
Kendra:
That's awesome. Thank you, Leticia, for your time today. And like she said, I hope that this has been maybe your first, maybe the first time you've heard a normal conversation about these kinds of things in a non punitive manner. I mean, really, we're just having a conversation and bringing awareness to this topic or this suggestion that maybe it's okay that we actually function at the top of our game. And how do we get there? And so thank you, Leticia. We honor you for the work you're doing, the, the ability that you had to just see there were gaps. And you were brave enough to consider yourself, you know, the expert, educate yourself, see what it was and all the different aspects.
And then now even taking it a step further and seeing, well, yeah, who's taking care of the patients. But then looking even beyond that on this side of the pandemic saying, Oh my gosh, who's taking care of these. Docs who's taking care of us and making us do it. So thank you. Thank you for encouraging us to know that, you know, our worth isn't wrapped up and showing up every day.
We're worth it because we're here and we have a lived experience. So thank you. Thank you. We appreciate you and your time today. Yeah, thank you all and for our listeners, if you have never joined our email list and you are ready to receive our weekly well check, which is a nice little nuggets delivered right to your inbox, please click the link below to join the list
And for more information, visit our website www. thewholephysician. com So until next time, you are whole, you are a gift to medicine, and the work you do matters.
